In order to provide background information for the invention, its purpose, and how it is an improvement over the prior art, it is necessary to explain the physical condition for which the invention was designed.
The therapeutic range-of-motion exercise device was intended to provide a means by which a person suffering from any weakness, stiffness, or debilitation of an arm or shoulder can practice range-of-motion exercises independently. For example, a person suffering arm and shoulder pain, stiffness, and weakness from arthritis, a stroke, or head-injured patient would greatly benefit from a device that could be used to exercise both in the hospital before release, and at home as part of ongoing therapy. Stroke or head-injured patients often suffer hemiplegia (i.e., a flaccidity of muscles on one half of the body, right or left depending on the side of the brain that sustained damage during the stroke). Flaccidity is an abnormally relaxed, flabby state of the muscles, but is not a true paralysis. Thus, therapy can improve muscle tone and even aid in recovery of the affected limb.
When one of the upper extremities is flaccid, the shoulder joint may become deformed (subluxated). In this situation, the flaccid arm pulls the long bone of the arm (humorous) out of the normal position in the shoulder socket. This dislocation occurs because the flaccid arm is heavy and the normal muscle tone that holds the humorous in the shoulder socket is gone.
To regain or maintain the muscle tone of the affected limb, range-of-motion exercises must be performed as a part of rehabilitation therapy. Range-of-motion exercises move the affected limb through the normal spatial arcs, loosening the muscles and preventing contractures (shortened muscles that prevent the joint from moving, often referred to as a "frozen" joint). Range-of-motion exercises are designed to prevent these disabling contracture and have traditionally been performed by skilled professionals in the hospital and then at home by a caregiver. Ideally, the patient would be transferred to a rehabilitation facility and additional intensive therapy would proceed. In reality, however, most patients do not have the resources or insurance to pay for continued therapy, and specialized facilities are often not logistically available.
Home therapy provided by the caregiver is often a problem. The problem stems not only from the necessity that the caregiver perform the range-of-motion exercises for the patient day after day, but also because these exercises are often painful; therefore, the patient will tend to resist letting the caregiver move the limb to the full extension of the normal spatial arcs. The solution to both of these problems is to give the patient the means to perform his own range-of-motion exercise so that he can exercise as often as necessary, and control the degree of pain he experiences during these exercises. Human nature dictates that a person in control of his own pain will be less fearful of pushing himself to his own limit, thus increasing rehabilitation benefits.
Heretofore, range-of-motion self-therapy for the upper extremities has consisted of placing the hand of the affected arm in a loop of soft rope or nylon line attached to an overhead pulley. The patient would then use the stronger arm to pull the other end of the rope or line to raise the weak arm. Although this method may increase and maintain a portion of the range of motion in the weakened limb, it does little to strengthen the muscles of the arm and shoulder girdle as does the invention herein described.
Another method of self-therapy currently practiced is to place a dust cloth in the hand of the patient's affected arm while he is seated at a table and instruct him to perform forward and back and wide circular motions. The patient will usually use the stronger arm to help the weak one to push the cloth. This simple method would probably work except for the fact that many patients with a considerable amount of debilitation from a stroke or head injury may also suffer a condition known as "aphasia" or "apraxia." This condition produces an inability to communicate verbally, and also inhibits the patient's comprehension of even simple verbal instructions. Therefore, the patient is often unable to perform the motion intended. Instead, he pushes the cloth a few inches forward and back or in small circles, gaining almost no range-of-motion benefit for his effort.
U.S. Pat. No. 4,134,584 to Rosenbusch, however, shows a "versatile arm skate." This skate provides arm and wrist exercise by requiring the patient to grasp a handle mounted on three rotatable casters and roll it along a flat surface. The device is purposely designed to tip over unless the patient exercises a somewhat precise muscular control to prevent the tipping. However, unless the patient's debilitation is minor, this exercise would be far too difficult to practice.
The object of the invention of this patent application is to provide the patient with an independent means to perform range-of-motion exercises. The patient is able to satisfy this objective by placing his hand in a push-along device, referred to herein as a "handguide," and pushing it along a pattern of grooves in the top of a flat rectangularly shaped board. The handguide is movably anchored to the board, enabling the patient to push it along the groove patterns, stretching the arm and working toward a plainly visible goal to complete the entire course.
The advantages of the invention disclosed herein over the prior art are that it provides a more effective means for the patient to perform his own exercise and push himself to his own limit, increasing the range-of-motion of the arm and shoulder, improving muscle tone and coordination in a patient who has almost none at the outset of therapy. The patient uses the strong hand and arm to help the weak one push the handguide along the groove patterns until the weak arm gradually gains enough strength and coordination to push the handguide along the grooves in the full range of motion.
The range-of-motion board is designed to be a relatively inexpensive alternative to hospital therapy. Range-of-motion therapy for stroke, head injured, or arthritic patients is an ongoing daily necessity that is often eventually neglected because health insurance runs out and the cost of a private therapist is prohibitive for most families. Caregivers, who are usually overburdened with the general care of the patient would benefit from the respite from performing therapy that having this device in the home would give them.